4 ms·

This is anecdotal at best, but when my grandfather passed last May from COVID, his death certificate did not record the cause of death as COVID. He tested nega

This is anecdotal at best, but when my grandfather passed last May from COVID, his death certificate did not record the cause of death as COVID. He tested negative twice after his month long bought with it, but only lived for another few weeks until dying of respiratory failure. We were told that because he was not testing positive at the time of death, his cause of death could not be recorded as COVID. I thought cause of death was whatever disease or injury started the chain of events that lead to one's death, but it felt like serious statistic manipulation. (edit - grammar)

CalChris 5y ago
My sister's a doc. Same anecdote. She had a patient who fell at home while severely weakened with COVID. Death certificate did not say COVID.
bsimpson 5y ago
Gets manipulated in the other direction too: financial incentives nudge hospitals to assign coronavirus as a cause of death if you had it when you died, even if it wasn't what actually killed you. I don't know if it's as blatant as "died in a car crash of coronavirus," but enough of my medical friends have mentioned it that I believe there's truth to it.
- vmception 5y ago
  Many tallies in the US were adjusted after this specific criticism over 8 months ago. But I guess the talking point won't be updated, oh well. My main issue with this criticism is that tallies of other illnesses have the same issues. So if an actual flu season said 20,000 people died, it had the same reporting issues and distribution of reporting issues. This means a direct comparison to two ailments with the same distribution of reporting issues gives you an accurate view of the affect. So even without going back and fixing the records - which I'm not sure you or other people even know happened - this means Covid deaths are more accurate and actually proves how it is much much worse. Anybody see the irony there? Given that the point of bringing attention to this would be to downplay the severity or response (or that there is a 100% correlation between the people that subscribe to these talking points and want a dramatically different response or no mitigation response at all), so, thanks for keeping healthcare authorities accountable, I guess.
- seoaeu 5y ago
  Since when are hospitals paid for having their patients die a specific way?
  - inetknght 5y ago
    Since the way you died affects how insurance pays out compensations.
    - mynameisvlad 5y ago
      Source? Hospitals bill based on services performed, not based on what the ailment is. Nowhere in my bills did it say I went in for a kidney stone last year.
      - deleted 5y ago
        [deleted]
  - whiddershins 5y ago
    Something to do with Medicare or maybe Medicaid.
  - fighterpilot 5y ago
    Medicare pays 20% more if they say that a patient has COVID[1]. [1] https://www.politifact.com/factchecks/2020/apr/21/facebook-posts/Fact-check-Hospitals-COVID-19-payments/ https://www.politifact.com/factchecks/2020/apr/21/facebook-p...
    - knowaveragejoe 5y ago
      > Our ruling > A post shared on Facebook claims hospitals have a financial incentive to claim patients had COVID-19, saying payment is three times higher if a patient goes on a ventilator. An article the post links to includes comments from a doctor who suggests the number of coronavirus cases is being padded. > It is standard for Medicare to pay roughly three times more for a patient with a respiratory condition who goes on a ventilator than for one who does not. That has nothing to do with the coronavirus. > As part of a federal stimulus bill, Medicare is paying hospitals 20% more than standard rates for COVID-19 patients. > Indications are that due to a lack of testing and other factors, the number of coronavirus cases has been undercounted, not padded. > For a statement that is partially accurate, our rating is Half True.
- throwkeep 5y ago
  Another financial incentive that exists: Families can get up to $9,000 for funeral expenses if the cause of death is listed as Covid. https://www.cnet.com/personal-finance/covid-funeral-reimbursement-now-9000-heres-how-to-apply-today/ https://www.cnet.com/personal-finance/covid-funeral-reimburs...
  - bdibs 5y ago
    Why would that incentivize the hospital though? Isn’t that who determines cause of death?
    - jcims 5y ago
      Lady calls in, her 450lb 57 year old son with uncontrolled type 2 diabetes and COPD is found dead at his home. Post-mortem test shows he's positive for COVID. You're the doctor, your hospital has had to furlough a quarter of their staff because nobody is coming in for any outpatient care, there's an ICU full of people on vents and you've been there for 18 hours already. The guys mom is there and you're working up her son's case. You have to fill in the blank for cause of death. What are you going to do? Order an autopsy and possibly cut this family out of government aid for COVID-related expenses and deaths?
    - throwkeep 5y ago
      Not necessarily the hospital itself, but with that kind of incentive it's going to find its way in. One possibility is family members applying pressure to compassionate doctors. “Show me the incentive and I'll show you the outcome” - Charlie Munger
      - ErikVandeWater 5y ago
        Fantastic quote!
- mywittyname 5y ago
  It's pretty difficult to prove covid was not a contributing factor to a person's death. So unless there's clear evidence it wasn't, it should be listed as a contributing factor. This isn't really any different than when a person dies some immediate event while also suffering from an underlying illness. If a leukemia patent suffers a an aneurysm, one would expect leukemia to be present on their death certificate.
  - betwixthewires 5y ago
    "It is pretty difficult to prove god does not exist, so unless there's clear evidence he doesn't, it should be assumed he does." The answer is the opposite, actually: if it is difficult to disprove any single contributor one way or another it should not be listed as a contributing factor.
- whatisthiseven 5y ago
  Isn't it plausible your medical friends mentioned it a lot because...others around them also mentioned it a lot? Doctors and nurses are just as capable as spreading rumors as anyone else.
- HideousKojima 5y ago
  There's at least one example of that I'm aware of: https://www.fox35orlando.com/news/fox-35-investigates-questions-raised-after-fatal-motorcycle-crash-listed-as-covid-19-death https://www.fox35orlando.com/news/fox-35-investigates-questi...
- digsy 5y ago
  > financial incentives nudge hospitals to assign coronavirus as a cause of death if you had it when you died, even if it wasn't what actually killed you. This accusation of fraud and malpractice has been a common talking point amongst those seeking to downplay COVID. But I've yet to see any evidence that its common or widespread.
nostromo 5y ago
Medicare pays out 20% more to the hospital if a patient is Covid-19 positive. So there's actually a strong financial incentive to report every possible Covid-19 case in the US.
- seppin 5y ago
  You are casually implying with no evidence that hospitals are intentionally misclassifying cases for financial reasons (which is a crime). Please do better. https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/ https://www.usatoday.com/story/news/factcheck/2020/04/24/fac...
nradov 5y ago
Death certificates can record both a primary cause and contributing factors. It's often a judgment call on what to consider as the cause and how far back in the chain of causality to go. There's no statistical manipulation there, just a lack of consistent standards.
Blahah 5y ago
More generally, there is no universally agreed way to record all the factors that contributed to a death at the time of death or certification. This is why excess deaths is the real metric by which the toll of this pandemic will be measured, at least in countries with reliable records about whether deaths happened at all.
- grumpyautist 5y ago
  Excess deaths doesn't work either. Gun violence has increased everywhere. So have suicides in my region of the world. I don't know who or why this comment got flagged, it doesn't change reality
  - Blahah 5y ago
    Excess deaths in a decent model account for other explanatory factors (war, sociopolitical things, etc.) that are not linked to the factor in question (covid-19 here). I'm not suggesting the crude arithmetical number of excess deaths is the key, but that a nuanced estimate of excess deaths in a model that accounts for other significant factors is a far better measure than anything else we have available.
mywittyname 5y ago
I'm pretty sure there have been non-detectable covid variants in the wild in the US for months now. I went through this with my mother, she was admitted to the hospital for a surgery and contracted some kind of "flu." She tested negative several times for covid. She stayed with me to convalesce and I came down with a "flu" in the middle of summer that had most of the symptoms of covid, except the loss of taste/smell. But my PCR test came back negative. I also had zero side-effects from my vaccine, which I understand is supposed to make people feel sick the day after the second dose.
- benmller313 5y ago
  Is the more likely scenario that you just had the seasonal Flu, or that there is a non detectable covid variant?
  - mywittyname 5y ago
    Summer isn't flu season. Multiple medical professions felt it was covid and recommended testing. Some of our symptoms weren't associated with flu, but were with covid. There are some 20 tracked covid variants spreading in the USA right now. Tracking of variants didn't begin until Dec. But even in the few months since they began tracking variant proportions, the dominant strains have shifted quite dramatically. T his is not some wacky conspiracy. Given this evidence, my money is on it was a variant of covid not tested for. You might see things differently, and that's fine.
    - Vecr 5y ago
      Okay, not Influenza, "flu", as in something that causes flu like symptoms. Quite a lot of virus can do that, as well as bacteria, allergies, etc. https://en.wikipedia.org/wiki/Influenza-like_illness https://en.wikipedia.org/wiki/Influenza-like_illness
welearnednothng 5y ago
I'm sorry for your loss. I had a similar experience in the US. In my case, a doctor flatly contributed the (impending) death a byproduct of COVID. All tests prior to COVID were positive and pointed to many more years ahead. I'm not certain, but I suspect something was lost in the handoff to the hospice care company where they just didn't have the history and I assume they were the ones that reported the COD. Not certain about this. I plan on looking to see if there's anyway to have this retroactively updated, but I'm not optimistic.
beams_of_light 5y ago
Similar story here - a family member contracted COVID in a nursing home, was sent to the hospital due to low blood oxygen levels, and was discharged. They passed away 2 weeks later, but the cause of death was not listed as COVID. I live in a red state, and for some reason, people are very hesitant to admit COVID can kill.
- seppin 5y ago
  > and for some reason We know why. It reflects poorly on the politician they've formed an emotional bond with.

CalChris 5y ago

My sister's a doc. Same anecdote. She had a patient who fell at home while severely weakened with COVID. Death certificate did not say COVID.

bsimpson 5y ago

Gets manipulated in the other direction too: financial incentives nudge hospitals to assign coronavirus as a cause of death if you had it when you died, even if it wasn't what actually killed you. I don't know if it's as blatant as "died in a car crash of coronavirus," but enough of my medical friends have mentioned it that I believe there's truth to it.

vmception 5y ago
Many tallies in the US were adjusted after this specific criticism over 8 months ago. But I guess the talking point won't be updated, oh well. My main issue with this criticism is that tallies of other illnesses have the same issues. So if an actual flu season said 20,000 people died, it had the same reporting issues and distribution of reporting issues. This means a direct comparison to two ailments with the same distribution of reporting issues gives you an accurate view of the affect. So even without going back and fixing the records - which I'm not sure you or other people even know happened - this means Covid deaths are more accurate and actually proves how it is much much worse. Anybody see the irony there? Given that the point of bringing attention to this would be to downplay the severity or response (or that there is a 100% correlation between the people that subscribe to these talking points and want a dramatically different response or no mitigation response at all), so, thanks for keeping healthcare authorities accountable, I guess.
seoaeu 5y ago
Since when are hospitals paid for having their patients die a specific way?
- inetknght 5y ago
  Since the way you died affects how insurance pays out compensations.
  - mynameisvlad 5y ago
    Source? Hospitals bill based on services performed, not based on what the ailment is. Nowhere in my bills did it say I went in for a kidney stone last year.
    - deleted 5y ago
      [deleted]
- whiddershins 5y ago
  Something to do with Medicare or maybe Medicaid.
- fighterpilot 5y ago
  Medicare pays 20% more if they say that a patient has COVID[1]. [1] https://www.politifact.com/factchecks/2020/apr/21/facebook-posts/Fact-check-Hospitals-COVID-19-payments/ https://www.politifact.com/factchecks/2020/apr/21/facebook-p...
  - knowaveragejoe 5y ago
    > Our ruling > A post shared on Facebook claims hospitals have a financial incentive to claim patients had COVID-19, saying payment is three times higher if a patient goes on a ventilator. An article the post links to includes comments from a doctor who suggests the number of coronavirus cases is being padded. > It is standard for Medicare to pay roughly three times more for a patient with a respiratory condition who goes on a ventilator than for one who does not. That has nothing to do with the coronavirus. > As part of a federal stimulus bill, Medicare is paying hospitals 20% more than standard rates for COVID-19 patients. > Indications are that due to a lack of testing and other factors, the number of coronavirus cases has been undercounted, not padded. > For a statement that is partially accurate, our rating is Half True.
throwkeep 5y ago
Another financial incentive that exists: Families can get up to $9,000 for funeral expenses if the cause of death is listed as Covid. https://www.cnet.com/personal-finance/covid-funeral-reimbursement-now-9000-heres-how-to-apply-today/ https://www.cnet.com/personal-finance/covid-funeral-reimburs...
- bdibs 5y ago
  Why would that incentivize the hospital though? Isn’t that who determines cause of death?
  - jcims 5y ago
    Lady calls in, her 450lb 57 year old son with uncontrolled type 2 diabetes and COPD is found dead at his home. Post-mortem test shows he's positive for COVID. You're the doctor, your hospital has had to furlough a quarter of their staff because nobody is coming in for any outpatient care, there's an ICU full of people on vents and you've been there for 18 hours already. The guys mom is there and you're working up her son's case. You have to fill in the blank for cause of death. What are you going to do? Order an autopsy and possibly cut this family out of government aid for COVID-related expenses and deaths?
  - throwkeep 5y ago
    Not necessarily the hospital itself, but with that kind of incentive it's going to find its way in. One possibility is family members applying pressure to compassionate doctors. “Show me the incentive and I'll show you the outcome” - Charlie Munger
    - ErikVandeWater 5y ago
      Fantastic quote!
mywittyname 5y ago
It's pretty difficult to prove covid was not a contributing factor to a person's death. So unless there's clear evidence it wasn't, it should be listed as a contributing factor. This isn't really any different than when a person dies some immediate event while also suffering from an underlying illness. If a leukemia patent suffers a an aneurysm, one would expect leukemia to be present on their death certificate.
- betwixthewires 5y ago
  "It is pretty difficult to prove god does not exist, so unless there's clear evidence he doesn't, it should be assumed he does." The answer is the opposite, actually: if it is difficult to disprove any single contributor one way or another it should not be listed as a contributing factor.
whatisthiseven 5y ago
Isn't it plausible your medical friends mentioned it a lot because...others around them also mentioned it a lot? Doctors and nurses are just as capable as spreading rumors as anyone else.
HideousKojima 5y ago
There's at least one example of that I'm aware of: https://www.fox35orlando.com/news/fox-35-investigates-questions-raised-after-fatal-motorcycle-crash-listed-as-covid-19-death https://www.fox35orlando.com/news/fox-35-investigates-questi...
digsy 5y ago
> financial incentives nudge hospitals to assign coronavirus as a cause of death if you had it when you died, even if it wasn't what actually killed you. This accusation of fraud and malpractice has been a common talking point amongst those seeking to downplay COVID. But I've yet to see any evidence that its common or widespread.

nostromo 5y ago

Medicare pays out 20% more to the hospital if a patient is Covid-19 positive. So there's actually a strong financial incentive to report every possible Covid-19 case in the US.

seppin 5y ago
You are casually implying with no evidence that hospitals are intentionally misclassifying cases for financial reasons (which is a crime). Please do better. https://www.usatoday.com/story/news/factcheck/2020/04/24/fact-check-medicare-hospitals-paid-more-covid-19-patients-coronavirus/3000638001/ https://www.usatoday.com/story/news/factcheck/2020/04/24/fac...

nradov 5y ago

Death certificates can record both a primary cause and contributing factors. It's often a judgment call on what to consider as the cause and how far back in the chain of causality to go. There's no statistical manipulation there, just a lack of consistent standards.

Blahah 5y ago

More generally, there is no universally agreed way to record all the factors that contributed to a death at the time of death or certification. This is why excess deaths is the real metric by which the toll of this pandemic will be measured, at least in countries with reliable records about whether deaths happened at all.

grumpyautist 5y ago
Excess deaths doesn't work either. Gun violence has increased everywhere. So have suicides in my region of the world. I don't know who or why this comment got flagged, it doesn't change reality
- Blahah 5y ago
  Excess deaths in a decent model account for other explanatory factors (war, sociopolitical things, etc.) that are not linked to the factor in question (covid-19 here). I'm not suggesting the crude arithmetical number of excess deaths is the key, but that a nuanced estimate of excess deaths in a model that accounts for other significant factors is a far better measure than anything else we have available.

mywittyname 5y ago

I'm pretty sure there have been non-detectable covid variants in the wild in the US for months now. I went through this with my mother, she was admitted to the hospital for a surgery and contracted some kind of "flu." She tested negative several times for covid. She stayed with me to convalesce and I came down with a "flu" in the middle of summer that had most of the symptoms of covid, except the loss of taste/smell. But my PCR test came back negative. I also had zero side-effects from my vaccine, which I understand is supposed to make people feel sick the day after the second dose.

benmller313 5y ago
Is the more likely scenario that you just had the seasonal Flu, or that there is a non detectable covid variant?
- mywittyname 5y ago
  Summer isn't flu season. Multiple medical professions felt it was covid and recommended testing. Some of our symptoms weren't associated with flu, but were with covid. There are some 20 tracked covid variants spreading in the USA right now. Tracking of variants didn't begin until Dec. But even in the few months since they began tracking variant proportions, the dominant strains have shifted quite dramatically. T his is not some wacky conspiracy. Given this evidence, my money is on it was a variant of covid not tested for. You might see things differently, and that's fine.
  - Vecr 5y ago
    Okay, not Influenza, "flu", as in something that causes flu like symptoms. Quite a lot of virus can do that, as well as bacteria, allergies, etc. https://en.wikipedia.org/wiki/Influenza-like_illness https://en.wikipedia.org/wiki/Influenza-like_illness

welearnednothng 5y ago

I'm sorry for your loss. I had a similar experience in the US. In my case, a doctor flatly contributed the (impending) death a byproduct of COVID. All tests prior to COVID were positive and pointed to many more years ahead. I'm not certain, but I suspect something was lost in the handoff to the hospice care company where they just didn't have the history and I assume they were the ones that reported the COD. Not certain about this. I plan on looking to see if there's anyway to have this retroactively updated, but I'm not optimistic.

beams_of_light 5y ago

Similar story here - a family member contracted COVID in a nursing home, was sent to the hospital due to low blood oxygen levels, and was discharged. They passed away 2 weeks later, but the cause of death was not listed as COVID. I live in a red state, and for some reason, people are very hesitant to admit COVID can kill.

seppin 5y ago
> and for some reason We know why. It reflects poorly on the politician they've formed an emotional bond with.